Tuberculin conversion after BCG vaccination: comparison by gestation and by age at immunization in Myanmar

Tun, Khin Myat; Win, Han; Oo, Aung Kyaw; Myint, San San; Hla, Sophia; Naing, H.

doi:10.1016/s0035-9203(00)90282-7

Cited by 5 publications

(5 citation statements)

References 6 publications

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“…By far, the most important determinant of DTH status after BCG vaccination in this population is the DTH response before vaccination (itself These findings are consistent with other study results. Detailed studies of schoolchildren in Denmark, Egypt, India, Mexico, and Pakistan [6] and a study in Myanmar [16] also found that most persons have a DTH response 2-3 months after BCG vaccination. The dramatic decrease in DTH response observed in this population, which occurs after the peak at 3 months, is similar to decreases reported in several tropical or subtropical populations-for example, the (less detailed) results from the southern India BCG trial [9] and studies in the Solomon Islands [17], Sri Lanka [18], and the southern United States [19].…”

Section: Discussionmentioning

confidence: 99%

Kinetics of Delayed‐Type Hypersensitivity to Tuberculin Induced by Bacille Calmette‐Guérin Vaccination in Northern Malawi

et al. 2002

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During 1986-1989, a bacille Calmette-Guérin (BCG) vaccine trial was carried out in northern Malawi. The effects of age, sex, and prevaccination delayed-type hypersensitivity (DTH) on the time course of the DTH response over 1-36 months after vaccination were studied in 2418 persons. DTH response increased rapidly, to peak at 31-90 days after vaccination, when most persons had a measurable response. This was followed by a marked decline by 181-365 days, particularly in those <15 years old at vaccination, followed by a more gradual decline. Prevaccination DTH was the single best predictor of postvaccination DTH. BCG-induced DTH responsiveness appears to decline more rapidly in tropical than in temperate environments. This may reflect high prevalence of exposure to other infections, which induce a Th2 bias or compete for "space" within the T lymphocyte compartment. The inability of some persons to mount a persistent DTH response probably reflects genetic background and/or environmental exposure history.

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Section: Discussionmentioning

confidence: 99%

Kinetics of Delayed‐Type Hypersensitivity to Tuberculin Induced by Bacille Calmette‐Guérin Vaccination in Northern Malawi

et al. 2002

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“…[113] Following the fourth dose of vaccine, all 44 children nogenicity of the influenza vaccine require further investigation. [118][119][120] In these studies 31-50% of premature tive mothers receive both hepatitis B immune globulin at birth and infants had no purified protein derivative (PPD) reaction, in cona four-dose series of HBV at birth, 1 month, 2-3 months, and 6-7 trast to 10-25% of full-term infants. A similar study of 82 infants of ties with high influenza immunization rates suggests that house-28-36 weeks' gestation at birth who received HBV at 0, 6, 10, and hold contact immunization may be useful in families of premature 14 weeks of age found that the number of infants with protective infants.…”

Section: Pneumococcusmentioning

confidence: 99%

Active Immunization of Premature and Low Birth-Weight Infants

D’Angio

2007

Pediatric Drugs

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Preterm infants are at increased risk of disease and hospitalization from a number of vaccine-preventable diseases. However, these same infants have immunologic immaturities that may impact vaccine responses. Larger premature infants mount immune responses to vaccines similar to those of full-term infants, but very premature infants (<28-32 weeks' gestation at birth) may have specific defects in vaccine responsiveness. Although there are minor differences in immunogenicity, the immune responses to diphtheria, tetanus, pertussis, and polio antigens are similar enough between full-term and premature infants that clinical consequences are unlikely to result. However, the immunogenicity of Haemophilus influenzae type b conjugate vaccines varies widely among studies of premature infants, and may be affected by the choice of conjugate protein, inclusion in a combination vaccine, and by an infant's overall health. Pneumococcal conjugate vaccine is efficacious in larger premature infants, but little information is available about immunogenicity in smaller premature infants. Meningococcal group C conjugate vaccine appears immunogenic in even very premature infants, but the duration of immunity may be limited. Hepatitis B vaccine given at birth appears poorly immunogenic in infants with birth weights <1500-2000 g, with delay in the administration of the first dose yielding improved immunogenicity. Few data on influenza vaccine in premature infants are available, but infants with pulmonary disease may respond less robustly than others. Bacille Calmette Guérin vaccine appears to be most immunogenic if delayed until at least 34-35 weeks' postmenstrual age in very premature infants, although there may be non-specific advantages to its earlier administration. Premature infants may have persistently lower antibody titers than full-term infants, even years after initial immunization. Sick premature infants experience increased episodes of apnea or cardiorespiratory compromise following vaccine administration, necessitating careful monitoring. Specific factors that impair immune response, quality of the immune response, and safety and immunogenicity evaluation of new vaccines in premature infants are topics needing further research. Premature infants are at significant risk for decisions from healthcare providers that delay beginning and completing their vaccine regimens. A major challenge facing those who care for these infants is the provision of timely immunization.

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“…Six studies 41 , 44 , 45 , 48 , 49 , 58 evaluated safety, with 4 reporting no vaccine-associated complications in infants who are preterm and/or LBW receiving early or delayed BCG vaccination.The RCT 48 in South Africa included 2419 neonates who had LBW and 2019 who were preterm who had all received early BCG vaccination; this study included detailed reporting of adverse reactions. Individual patient data were obtained and post hoc comparisons made with 8299 infants who were full term and/or had NBWs and received early BCG vaccination.…”

Section: Resultsmentioning

confidence: 99%

“…After removal of duplicate data and screening, 40 articles were identified (Figure 1). 14,20,21,22,23,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65 Most studies were prospective cohorts or randomized clinical trials, conducted predominantly between 1990 and 2017 in Africa (k = 14 [where k indicates the number of studies]), Asia (k = 10), Europe (k = 8), South America (k = 5) and the Middle East (k = 3). One study included 2019 infants who were preterm and 2419 newborns who had LBW who had received early BCG vaccination but did not report safety outcomes independently from infants who were full term and/or had NBWs.…”

Section: Resultsmentioning

confidence: 99%

“…No vaccine-associated complications in infants who were preterm were reported in another study of early BCG vaccination 38 and 2 studies of delayed vaccination. 39,40 Studies Comparing infants Who Are Preterm and/or had LBW With Infants Who Are Full-Term and/or had NBWs Six studies 41,44,45,48,49,58 evaluated safety, with 4 reporting no vaccine-associated complications in infants who are preterm and/or LBW receiving early or delayed BCG vaccination.The RCT 48 in South Africa included 2419 neonates who had LBW and 2019 who were preterm who had all received early BCG vaccination; this study included detailed reporting of adverse reactions. Individual patient data were obtained and post hoc comparisons made with 8299 infants who were full term and/or had NBWs and received early BCG vaccination.…”

Section: Descriptive Studies Of Early or Delayed Bcg Vaccination Of I...mentioning

confidence: 99%

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Safety and Immunogenicity of Early Bacillus Calmette-Guérin Vaccination in Infants Who Are Preterm and/or Have Low Birth Weights

et al. 2019

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Key Points Question Is administration of bacillus Calmette-Guérin (BCG) vaccination within 7 days of birth safe, immunogenic, and efficacious in infants who are preterm and/or have low birth weight, compared with BCG vaccination at later points or in infants who are normal birth weight? Findings In this systematic review and meta-analysis, we found no increase in adverse reactions or infant mortality after BCG vaccination within 7 days of birth compared with vaccination delayed after 7 days in clinically stable infants who were preterm and/or had low birth weight. Meta-analysis revealed no differences for scar formation or tuberculin skin test conversion. Meaning Currently, evidence from clinically stable infants who were born after more than 30 weeks’ gestational age and/or weighing more than 1.5 kg seems to support BCG vaccination within 7 days of birth.

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Tuberculin conversion after BCG vaccination: comparison by gestation and by age at immunization in Myanmar

Cited by 5 publications

References 6 publications

Kinetics of Delayed‐Type Hypersensitivity to Tuberculin Induced by Bacille Calmette‐Guérin Vaccination in Northern Malawi

Kinetics of Delayed‐Type Hypersensitivity to Tuberculin Induced by Bacille Calmette‐Guérin Vaccination in Northern Malawi

Active Immunization of Premature and Low Birth-Weight Infants

Safety and Immunogenicity of Early Bacillus Calmette-Guérin Vaccination in Infants Who Are Preterm and/or Have Low Birth Weights

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